1. EPISTAXIS
AMAN OPNEJA

2. BLOOD SUPPLY
NASAL SEPTUM
OF

3. EXTERNAL CAROTID ARTERY
FACIAL ARTERY MAXILLARY
ARTERY
SUPERIOR
LABIAL
ARTERY
GREATER
PALATINE
ARTERY
SEPTAL BRANCH
SPHENO-
PALATINE
NASOPALATINESEPTAL BRANCH

5. INTERNAL CAROTID ARTERY
 ANTERIOR ETHMOID ARTERY
 POSTERIOR ETHMOID ARTERY

8. LITTLE’s AREA
 1/2 INCH FROM THE CAUDAL BORDER OF
SEPTUM ANTERO-INFERIORILY.
 VESSELS ANASTOMOSING ARE:
 ANTERIOR ETHMOID
 GREATER PALATINE
 SPHENOPALATINE
 SEPTAL BRANCH OF SUPERIOR LABIAL.

9. LITTLE’s AREA

10. WOODRUFF’s PLEXUS
 INFERIOR TO POSTERIOR END OF
INFERIOR TURBINATE
 FREQUENT SITE OF ADULT EPISTAXIS
 VENOUS PLEXUS

11. CAUSES
OF
EPISTAXIS

12. LOCAL CAUSES
TRAUMATIC
 NASAL FRACTURE WITH
DISRUPTION OF THE NASAL
MUCOSA
 NASAL SURGICAL
PROCEDURE
 NASAL INTUBATION
 DIGITAL TRAUMA
 NASAL FOREIGN BODY
 ANTIHISTAMINICS AND
STEROID NASAL SPRAY
 NASAL OXYGEN OR
CONTINOUS POSITIVE AIRWAY
BREATHING

13. STRUCTURAL
 NASAL SEPTAL DEFORMITY
( DEFLECTIONS AND SPUR )
 SEPTAL PERFORATIONS

14. INFLAMMATORY DISEASE
 VIRAL UPPER RESPPIRATORY TRACT INFECTION
 BACTERIAL SINUSITIS
 ALLERGIC SINUSITIS
 PYOGENIC GRANULOMA
 GRANULOMATOUS DISEASE ( WEGNER’S GRANULOMATOSIS,
TUBERCULOSIS, SARCOIDOSIS, SYPHILLIS)
 ENVIRONMENTAL IRRITANT ( CIGARETTE SMOKING, CHEMICALS,
POLLUTION)

15. TUMOUR
OR
VASCULAR
MALFORMATIONS
 ANGIOFIBROMA
 ANEURYSMS
 EPIDERMOID CARCINOMAS
 NASAL PAPILLOMA
 ADENOCARCINOMA
 ENCEPHALOMA
 ESTHESIONEUROBLASTOMA
 HEMANGIOMA

16. SYSTEMIC CAUSES
COAGULATION DEFICITS
 THROMBOCYTOPENIA
 ACQUIRED COAGULOPATHY
 CONGENITAL CPAGULOPATHY
 VITAMIN A, D, C, E & K DEFICIENCY
 LIVER DISEASE
 RENAL FAILURE
 CHRONIC ALCOHOL ABUSE
 MALNUTRITION
 POLYCYTHEMIA VERA
 MULTIPLE MYELOMA

17.  LEUKEMIA
 ANTICOAGULANT DRUGS
 ASPIRIN
 HEPARIN
 WARFARIN

18. VASCULAR DISEASE
 ARTERIOSCLEROSIS
 COLLAGEN ABNORMALITIES
 HEREDITY HEMORRHAGIC TELANGIECTASIA

19. CARDIOVASCULAR CONDITION
THAT INCREASE VENOUS PRESSURE
 CHF
 MITRAL VALVE STENOSIS
HYPERTENSION
UNPROVEN RELATIONSHIP

20. CLASSIFICATION
OF
CAUSES OF EPISTAXIS
1. BASED ON LOCATION
2. BASED ON ETIOLOGY
3. BASED ON CAUSE

21. THANK YOU